O03 Impact of prep on sexual behaviour? significantly lower rate of rectal ct in non-prep users in the deferred phase of proud disappeared when everyone had access to prep

Abstract

IntroductionPROUD is uniquely placed to compare rates of STIs between PrEP users and non-PrEP users, and to provide longitudinal data in PrEP users between Nov12–Nov16. We describe reported STIs in the year prior to enrolment, and rates during the deferred and post-deferred phases of PROUD when all participants had access to PrEP.MethodsData were extracted from baseline self-completed questionnaires. Staff were asked to capture STI screens and diagnoses from quarterly study and interim routine clinic visits. We compared incidence rates of selected STIs for those with immediate (IMM) access to deferred (DEF) access during the deferred and post-deferred phase.Results517 participants completed the STI baseline questions, reporting a median (IQR) of 3 (2–4) screens in the 12m prior to enrolment; 172 (89 IMM, 83 DEF) reported a rectal infection. Rectal STI rates were similar by phase and arm with the exception of lower rates of rectal CT in the DEF arm during the deferred phase (p-value=0.024):Abstract O03 Table 1Rectal infections in PrEPDeferred PhasePost-deferred PhaseRate (N/pyrs)IMMDEFIMMDEFRectal GC35.3 (81/229)33.7 (67/203)31.4 (129/411)32.7 (116/355)Rectal CT33.6 (77/229)21.2 (43/203)33.1 (136/411)29.9 (106/355)DiscussionThe ongoing high rates of rectal infections show that participants remaining in follow-up continued to need PrEP. The significantly reduced incidence of rectal CT in those allocated to deferred PrEP was not observed in the post-deferred phase when everyone had access to PrEP. This may be chance or may reflect an influence of PrEP on sexual practices.